We chose to use a common value set for medical, system and patient reasons because the reason needs to be associated with the particular element and a physician would most likely not include an unrelated reason. For instance, it is unlikely a physician will cite drug-resistance as the reason he did not perform a falls risk assessment. We thought using one value set for all measures would reduce burden on the measure programmers as they could always refer to the same value set, while not introducing error. In addition, Medical or Other reason not done SNOMED-CT Value Set may not be complete as there are other applicable codes in the larger value set, such as "not indicated (qualifier value)" and "complication of medical care (disorder)." CMS and ONC are currently working on a more technically correct approach to the "not done" concept for medications and other data types. The proposed approach suggests the use of the "null flavor" "not applicable". The downstream effects of this approach are currently under investigation and CMS and ONC anticipate publishing guidance on the definitive solution to this problem when it has been tested and approved. In the interim, we welcome comments regarding the feasibility of this proposed solution.